Comparative study of visual outcome of newly designed scleral tuck lens and suture-fixated lens for rehabilitation of aphakia in various aetiologies

Purpose:Visual rehabilitation in aphakia can be performed using several modalities. However, these modalities could be either technically difficult or expensive. Herein, we developed a scleral tuck lens to provide a simple and cost-effective solution for aphakia and compared its outcome with standard methods.Methods:A specially designed posterior chamber self-sustaining lens was implanted in patients with aphakia without capsular support because of different primary etiologies. The visual outcomes, as well as intraoperative and postoperative complications, were examined. The data were retrieved from electronic medical records, and visual outcome and complication rates were compared. The outcomes were also compared according to the etiology and age groups (pediatric and adults).Results:We found significant improvement in preoperative and postoperative visual outcome. We did not find any significant difference in visual outcome amongst suture-supported scleral fixated lens with scleral tuck lens.Conclusion:Satisfactory visual outcomes were noted with minimal complications; and comparable with gold standard suture fixated lens, however long-term follow-up is required.     

COVID-19-associated mucormycosis and treatments

In the current pandemic, COVID-19 patients with predisposing factors are at an increased risk of mucormycosis, an uncommon angioinvasive infection that is caused by fungi with Mucor genus which is mainly found in plants and soil. Mucormycosis development in COVID-19 patient is related to various factors, such as diabetes, immunocompromise and neutropenia. Excessive use of glucocorticoids for the treatment of critically ill COVID-19 patients also leads to opportunistic infections, such as pulmonary aspergillosis. COVID-19 patients with mucormycosis have a very high mortality rate. This review describes the pathogenesis and various treatment approaches for mucormycosis in COVID-19 patients, including medicinal plants, conventional therapies, adjunct and combination therapies.     

Development and Characterizations of Pullulan and Maltodextrin-Based Oral Fast-Dissolving Films Employing a Box–Behnken Experimental Design

Migraine is a neurological disorder characterized by severe headaches, visual aversions, auditory, and olfactory disorders, accompanied by nausea and vomiting. Zolmitriptan (ZMT^®) is a potent 5HT1B/1D serotonin receptor agonist frequently used for the treatment of migraine. It has erratic absorption from the gastrointestinal tract (GIT), but its oral bioavailability is low (40–45%) due to the hepatic metabolism. This makes it an ideal candidate for oral fast dissolving formulations. Hence, the current study was undertaken to design and develop oral fast-dissolving films (OFDFs) containing ZMT for migraine treatment. The OFDFs were formulated by the solvent casting method (SCM) using Pullulan (PU) and maltodextrin (MDX) as film-forming agents and propylene glycol (PG) as a plasticizer. The strategy was designed using Box–Behnken experimental design considering the proportion of PU:MDX and percentage of PG as independent variables. The effectiveness of the OFDF’s was measured based on the following responses: drug release at five min, disintegration time (D-time), and tensile strength (TS). The influence of formulation factors, including percent elongation (%E), thickness, water content, moisture absorption, and folding endurance on ZMT-OFDFs, were also studied. The results showed a successful fabrication of stable ZMT-OFDFs, with surface uniformity and amorphous shape of ZMT in fabricated films. The optimized formulation showed a remarkable rapid dissolution, over 90% within the first 5 min, a fast D-time of 18 s, and excellent mechanical characteristics. Improved maximum plasma concentration (C max) and area under the curve (AUC 0–t) in animals (rats) treated with ZMT-OFDFs compared to those treated with an intra-gastric (i-g) suspension of ZMT were also observed. Copolymer OFDFs with ZMT is an exciting proposition with great potential for the treatment of migraine headache. This study offers a promising strategy for developing ZMT-OFDFs using SCM. ZMT-OFDFs showed remarkable rapid dissolution and fast D-time, which might endeavor ZMT-OFDFs as an auspicious alternative approach to improve patient compliance and shorten the onset time of ZMT in migraine treatment.     

Pyridine: the scaffolds with significant clinical diversity

The nitrogen-bearing heterocycle pyridine in its several analogous forms occupies an important position as a precious source of clinically useful agents in the field of medicinal chemistry research. This privileged scaffold has been consistently incorporated in a diverse range of drug candidates approved by the FDA (Food and Drug Administration). This moiety has attracted increasing attention from several disease states owing to its ease of parallelization and testing potential pertaining to the chemical space. In the next few years, a larger share of novel pyridine-based drug candidates is expected. This review unifies the current advances in novel pyridine-based molecular frameworks and their unique clinical relevance as reported over the last two decades. It highlights an inclination to the use of pyridine-based molecules in drug crafting and the subsequent emergence of several potent and eligible candidates against a range of diversified diseases.

The nitrogen-bearing heterocycle pyridine in its several analogous forms occupies an important position as a precious source of clinically useful agents in the field of medicinal chemistry research.     

Isolated partial tear of extensor digitorum longus tendon with overlying muscle herniation in acute ankle sports injury: role of high resolution musculoskeletal ultrasound

Lateral Ankle sprain is a common sports-related trauma with the mechanism of injury ranging from inversion to plantar flexion. These injuries commonly affect the ligaments but can also affect the associated soft tissue structures like the eversion muscles and tendons. Prompt and accurate diagnosis of such injuries is warranted so as to ensure early return to play and prevent long-term complications. Lateral ankle sprain injuries in sports may not always be associated with ligament injuries. We report a never before reported case of lateral ankle sprain injury in a soccer player with the unusual finding of isolated partial tear of Extensor digitorum longus muscle and its fascia leading to myo-fascial herniation. The lateral ankle ligaments were intact. The diagnosis was clinched on a high-frequency ultrasound scan supported by dynamic maneuvers which in fact proved to be superior to MRI as the latter failed to demonstrate the myo-fascial herniation in our case. We therefore propose that real-time ultrasound scanning with dynamic maneuvers should be the first line of investigation to assess sports injuries in anatomically complex joints like the ankle.     

Use of Gamma-Irradiated Cornea to Plug Sclerostomy Site During Tube Shunt Revision

Tube shunt implantation is a common procedure for control of intraocular pressure (IOP). However, tube revision and repositioning must sometimes be performed, and this involves removing the tube from its sclerostomy site. This site is prone to leaking and this may cause postoperative hypotony. We describe a novel and cosmetically acceptable technique of plugging and covering the sclerostomy site with gamma-irradiated corneal tissue.     

Clinical potential of tensionlengthening strategies during nerve repair

<正>A (very) brief history of tension in nerve repair:Successful nerve repair is achieved by conveying as many axons successfully to their targets as possible.Typically,this is best achieved through a direct end-to-end repair under minimal tension (Millesi,1986).However,this is not feasible in most cases of trauma,where a segment of tissue damage must be excised and overcome.This has most commonly been addressed with the use of nerve grafts to bridge the gap.Autologous nerve grafts are cons...